低分子肝素对老年髋关节置换术后患者住院期间下肢深静脉血栓形成的影响

Effect of low molecular weight heparin on lower extremity deep venous thrombosis in elderly patients after hip replacement

目的探讨低分子肝素对老年髋关节置换术后患者住院期间下肢深静脉血栓形成的影响。方法收集2018年3月至2022年5月于首都医科大学附属北京天坛医院接受髋关节置换术治疗的80例老年患者的临床资料,根据是否使用低分子肝素将患者分为治疗组和对照组,每组40例。观察并比较两组患者术后住院期间下肢深静脉血栓形成的发生情况、D-二聚体水平及出血情况。结果两组患者的疾病类型、手术相关指标比较,差异均无统计学意义(P﹥0.05)。术后住院期间,治疗组患者D-二聚体水平升高的比例为7.5%(3/40),低于对照组患者的25.0%(10/40),差异有统计学意义(P=0.034)。下肢深静脉超声复查结果显示,治疗组患者下肢深静脉血栓的发生率为5.0%(2/40),低于对照组患者的20.0%(8/40),差异有统计学意义(P=0.042)。两组患者住院期间均无出血现象发生。结论低分子肝素可以安全、有效地预防老年髋关节置换术后患者住院期间下肢深静脉血栓形成。

Objective To investigate the effect of low molecular weight heparin on lower extremity deep venous thrombosis in elderly patients after hip replacement.Method The clinical data of 80 elderly patients who underwent hip arthroplasty at Beijing Tian Tan Hospital,Capital Medical University from March 2018 to May 2022 were collected.According to the employment of low molecular weight heparin,the patients were divided into treatment group and control group with 40 cases in each group.The incidence of lower extremity deep venous thrombosis,D-dimer level,and bleeding during postoperative hospitalization were observed and compared between the two groups.Result There were no statistically significant differences in disease types and surgery-related indicators between the two groups(P>0.05).During postoperative hospitalization,the proportion of elevated D-dimer in the treatment group was 7.5%(3/40),which was lower than 25.0%(10/40)in the control group,and the difference was statistically significant(P=0.034).The results of deep venous ultrasonography of the lower extremities showed that the incidence of deep venous thrombosis in the treatment group was 5.0%(2/40),which was lower than 20.0%(8/40)in the control group,and the difference was statistically significant(P=0.042).There were no bleeding events in the two groups of patients during hospitalization.Conclusion As a safe and effective medication,low molecular weight heparin could prevent lower extremity deep venous thrombosis during hospitalization in elderly patients after hip replacement.